Fall/pain/warmth 2 years after ulnar shortening osteotomy
I'm a 29 y/o female and four and a half years ago I broke my arm in a work accident. Despite complaints of ulnar sided pain, I was told I only broke my radius. About five months after injury, they finally listened and realized I broke my ulnar styloid and tore my TFCC. I moved to a different state and had another delay, but ended up having surgery to try to repair the TFCC about a year and a half after tearing it. That didn't work, so six months later I had the TFCC removed and an ulnar shortening osteotomy. That was two and a half years ago. The plate hasn't really bothered me much and due to being out of work for the other two surgeries, I haven't gone to have it removed.
Anyway, just over a week ago I fell in my bathroom and, because I guard that arm and didn't put out my hand to catch my fall, I landed flat on the arm. I've a small not too painful knot on my proximal ulna, but about three days after the fall I developed intense pain at the distal end of the plate. I went in for an x-ray, but they said the plate/screws were fine and there was no break in the bone. I have also moved again since my surgery, so I am not able to see the surgeon who did the surgery.
It's been a little more than a week since the fall and the pain has not gotten better, if anything it is worse. It hurts to pronate/supinate/rest my arm on ANYTHING. Pressure applied to the ulna hurts, pressure applied to dorsal and ventral sides of my forearm hurts. Pressure on my radius doesn't really bother me. Simply moving my arm around in the air hurts. Wrist flexion and extion hurt. The pain I have is along the same lines of the pain after the osteotomy, but worse. I wasn't in this much pain a week after surgery! It seems that there is a little swelling at the distal plate and it feels warm, but it not pink or red.
Is this normal for a blow to the arm after a plate is in? Does it sound like a soft tissue injury?
Patients are always more sensitive over plates and screws, so it certainly could be something as simple as that. There may be some micromotion at the osteotomy site, that is not seen on the xray, because the plate masks it, there may even be an injury to the bone under the plate. However, as long as the plate remains in place, and there is no loosening, either one of these should heal. Give it several weeks of rest, if the pain persists, see a local hand specialist, or travel back and see your treating surgeon.
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